Black Sesame in the Kitchen Holds the Key to a Meridian: When Both the Back of the Head and the Heels Are Peeling

Deep in the spice rack of the kitchen sits a small jar of black sesame. It is rarely remembered, yet it always quietly steps in when needed—scattered over rice balls, tossed into cold dishes, or simply resting in a corner. Black sesame appears jet-black on the outside and is oily within; a gentle pinch is enough to release oil from the fingertips. From the perspective of traditional Chinese medicine (TCM), this tiny seed happens to embody the underlying logic of treating a certain type of bodily imbalance: the surface may look dry and flaky, but the interior is not necessarily truly "deficient in water." The key lies in whether essential essence and blood can nourish the most distant corners of the body. Peeling skin on both the back of the head and the heels is precisely a typical microcosm of this type of problem.

I. Why Do These Two Areas Specifically Develop Scaling?

The back of the head and the heels—one at the top, one at the bottom, far apart—why would they develop scaling at the same time? This is the first question on many people's minds.

The Miraculous Pivot · Meridians Chapter 10 of the Yellow Emperor's Inner Canon records the pathway of the Foot Shaoyin Kidney Meridian: "It arises from beneath the small toes, runs obliquely across the sole, emerges below the Rangu point (KI2), follows behind the medial malleolus, and enters the heel." This passage explicitly states that the Kidney Meridian "enters the heel"—the heel is exactly where the Kidney Meridian passes. As for the back of the head, in TCM meridian theory it belongs to the convergence area of the Governing Vessel (Du Meridian) and the Bladder Meridian, and the Governing Vessel "runs through the spine and connects with the Kidney," so its relationship with the Kidney is equally close.

TCM theory holds that the Kidney governs the storage of essence, and its luster is manifested in the hair. Whether the hair is moist and glossy directly reflects the fullness of kidney essence. Scaling on the back of the head can be understood as insufficient nourishment of kidney essence to the head; scaling on the heels reflects a deficiency in the "irrigation" at the terminal end of the Kidney Meridian. The same root cause (kidney essence insufficiency) manifests as similar symptoms at the upper and lower ends of the body through different meridian pathways.

Traditional Chinese medicine holds that essence and blood share a common source and mutually transform each other. When kidney essence is deficient, the production of blood is weakened; blood deficiency engenders dryness, and the skin loses its moisture. Dryness tends to be desiccating and injures body fluids; on the body surface, this manifests as scaling and fissuring. It should be noted that scaling is not always simply "dryness." Some people have dry, fine, powdery flakes that fall off at the slightest scratch; others have stickier, thicker scales that cling to the scalp or heels and are not easily shed. The pathological mechanisms behind these two forms differ, and the principles of treatment also have their respective emphases.

This leads to a key question: with the same symptom of scaling, why are the forms so different? This is precisely the entry point for the TCM concept of "treating the same disease with different methods." Dry, fine flaking is mostly related to deficiency of yin and blood, engendering wind and dryness; greasy, thick scaling, on the other hand, is often complicated by dampness and heat, with a more complex pathological mechanism. Clinically, one must first distinguish whether dryness or dampness dominates—the two require entirely different approaches: the former needs "adding water," while the latter needs "regulating qi and resolving dampness." If the direction is reversed, the discomfort may actually worsen.

1. Kidney Essence Deficiency as the Background, Dampness Obstruction as the Variation

From the clinical characteristics of affected groups, the condition of scaling on both the back of the head and the heels is most often seen in people with relatively deficient kidney essence combined with dampness. Such individuals often not only have scaling but may also present with soreness and weakness of the lower back and knees, dull pain in the heels, and frequent nighttime urination. Interestingly, they do not all appear "dry"—some have obvious scalp oiliness while their heels are rough and fissured, presenting a contradictory state of "oily on top, dry on the bottom."

The Plain Questions · Yin and Yang Corresponding to the Phenomena of Nature, Chapter 5 says: "At the age of forty, yin qi has naturally declined by half, and one's daily activities begin to weaken." This classic statement highlights the relationship between age and the consumption of yin essence. As a person ages, yin essence naturally declines; after the age of forty or fifty, yin qi has already consumed more than half, the nourishing function weakens, and the "peripheral" areas such as skin, hair, and nails are the first to be affected. Scaling on the back of the head and roughness on the heels can be understood as the body signaling that the "balance" of kidney essence reserves is no longer as ample as before.

But kidney essence deficiency alone cannot explain all phenomena. Clinically, a considerable number of people are in a state of "upper heat and lower cold" or "downward pouring of turbid dampness." The Spleen governs the transportation and transformation of water-dampness. If spleen yang is weakened, water-dampness accumulates internally; dampness tends to descend, easily flowing into the heel area, obstructing the movement of qi and blood, and causing local skin to lose nourishment and scale. This type of scaling is often accompanied by sticky stools, a heavy sensation in the body, and a white, greasy tongue coating. At the same time, dampness ascending to disturb the clear orifices can also affect sebum secretion in the back-of-head area, forming sticky-type scales.

2. The Yin-Yang Perspective: Scaling Is Not Merely a Matter of "Lack of Water"

Now let us return to the original question: does scaling necessarily require "replenishing water"? The answer is not that simple. From the perspective of yin-yang theory, the human skin requires the coordinated action of yin and yang to maintain normal moisture and metabolism. Yin fluid provides the material basis, while yang qi is responsible for transportation, distribution, and vaporization. If yang qi is insufficient and unable to deliver body fluids to the body surface and extremities, the skin will still become dry and flaky even if the body is not short of water. This is like a heating system where the pipes are unobstructed but the boiler's fire is insufficient—the hot water cannot reach the distant radiators, and the room naturally fails to warm up.

This type of yang-deficiency scaling is more common in people who sit for long periods, lack exercise, or overconsume cold and raw foods. Their scaling areas tend to be on the posterior side of the body—the back of the head, the back, and the heels. This is because the posterior side of the human body belongs to yang, and the Governing Vessel governs the yang qi of the entire body. When yang qi is weak, these "yang positions" are precisely the first to lose nourishment. Such individuals often feel cold, have cold hands and feet, are easily fatigued, and have a pale or dull complexion.

It should be emphasized that the states of yin-blood deficiency and yang-qi insufficiency are not completely separate. Clinically, many people are in a transitional phase of "deficiency of both yin and yang," presenting with both yin-deficiency signs such as dry mouth, dry throat, and heat in the palms and soles, and yang-deficiency signs such as fear of cold, cold limbs, and loose stools. This interwoven situation is not uncommon in TCM pattern differentiation. For this reason, self-diagnosis can easily be biased. It is recommended that those with such concerns consult a licensed TCM practitioner for comprehensive identification through the four diagnostic methods.

II. From Pattern Differentiation to Nurturing: TCM Approaches to Scaling

When scaling recurs, many people's first reaction is to change their shampoo or apply moisturizer, but the results are often unsatisfactory. From a TCM perspective, such methods are like spraying water on withered leaves—the leaf surface is temporarily moistened, but the root problem remains unresolved. Only by regulating essence and blood at the source and restoring the function of the internal organs can the condition truly improve.

1. The Role of the Spleen and Stomach in Nourishing Essence and Blood

When it comes to supplementing kidney essence, people often think of various "like-nourishes-like" foods. Yet few realize that the spleen and stomach are the source of essence and blood production. When food enters the stomach, it is transformed by the spleen and stomach through their transportation and transformation functions; only then can refined nutrients be converted into qi, blood, and body fluids to further nourish kidney essence. If the spleen and stomach are weak and unable to transport and transform properly, no matter how many nourishing foods are consumed, they cannot be converted into usable refined substances; instead, they may stagnate in the middle burner and generate turbid dampness.

The Plain Questions · Discussion on the Separate Meridians, Chapter 21 explicitly describes this process: "When fluid enters the stomach, it disperses its essence and sends it upward to the spleen. The spleen, in turn, spreads the essence upward and returns it to the lungs. The lungs regulate the water channels and send it downward to the bladder." This original passage reveals an important fact: the distribution of body fluids is a cooperative process involving multiple organs, with the spleen and stomach at the source. The spleen sends refined essence upward to the lungs, and the lungs disseminate and descend it before it can reach the four limbs and all hundred bones.

Therefore, for nurturing the body in cases of scaling, the diet should be gentle and nourishing rather than excessively supplemented. In daily life, one may appropriately consume black sesame, mulberry, walnut, and similar foods, all of which help nourish kidney essence. However, the key lies in "moderation" and "long-term consistency" rather than a single large intake. At the same time, one should avoid excessive consumption of cold, raw, greasy, and fatty foods, so as not to impair the transportation and transformation function of the spleen and stomach. Dietary regulation should start with daily habits: chewing slowly, eating meals at regular times, and reducing cold and raw foods—these seemingly basic practices are precisely the most important care for the spleen and stomach.

In terms of daily routine, traditional health cultivation emphasizes "rise with the sun, rest with the sun." The night hours are when yin qi collects and yang qi lies hidden; staying up late is the most damaging to kidney essence. People who stay up late for long periods tend to have more pronounced scaling on the back of the head and roughness of the heel skin. If one can achieve deep sleep during the nighttime hours, this supports the repair and replenishment of essence and blood in a way that no daytime nourishing food can replace.

2. Nurturing Emphasis for Those Troubled by Dampness

For those with dampness-type scaling (sticky scales, heavy body sensation, thick and greasy tongue coating), the nurturing approach should shift toward "strengthening the spleen and resolving dampness." The diet of such individuals should be light and plain, with less fatty, sweet, and greasy foods. Traditional Chinese medicine holds that "sweetness can engender dampness," and excessive sweets will aggravate the accumulation of turbid dampness in the body. Coarse grains, miscellaneous beans, winter melon, and coix seed are helpful for strengthening the spleen and draining dampness, but whether they are suitable for a specific individual still requires judgment according to one's own constitution.

Emotional regulation is another dimension that is easily overlooked. TCM theory states that "the liver and kidney share a common source." The liver governs free coursing, while the kidney governs storage and sealing; the two act as one opens and one closes, maintaining the dynamic balance of qi movement. Long-term anxiety, suppression, and irritability all affect the liver's free-coursing function and thereby interfere with the kidney's storage function. Many people find that their scaling worsens when stress increases and sleep deteriorates—this is exactly the reason. It is recommended to moderately relieve emotions through walking, listening to music, talking with friends, and similar activities. There is no need to pursue "complete freedom from anxiety," but try not to keep emotions in a tense state for too long.

In terms of exercise and guiding exercises, traditional health cultivation emphasizes that "movement engenders yang." Moderate activity helps the flow of qi and blood and improves peripheral blood supply. However, one should act within one's capacity, as excessive exercise can consume and injure qi and blood. Gentle forms of exercise such as walking, tai chi, and eight-section brocade (Baduanjin) are all good options. The reference point is to feel slight sweating after exercise and not feel exhausted. Which specific exercise suits one can be flexibly chosen based on one's physical condition, without being constrained to a fixed pattern.

3. Constitution Identification and Seasonal Factors

Scaling is closely related to seasonal changes. In autumn and winter, the qi of dryness prevails, the external environment is dry, sebaceous gland secretion decreases, and people who already have a foundation of essence-blood deficiency are more prone to skin scaling. In late spring and early summer, dampness gradually increases, and people troubled by dampness obstruction may experience increased dandruff and obvious oiliness. Observing how scaling waxes and wanes with the seasons helps determine whether one tends more toward dryness or dampness.

Clinically, if some people also present with cracked heels, soreness and weakness of the lower back and knees, and frequent nighttime urination, the condition may be more closely related to kidney essence deficiency; if they present with a heavy sensation in the head as if wrapped, sticky stools, and a sticky sensation in the mouth, then dampness plays a larger role. These manifestations are not absolute, and many people present with mixed states. Regardless of which end one leans toward, the key to nurturing lies in restoring the body's internal balance, not in clinging to a single "targeted method."

Peeling on both the back of the head and the heels may seem like a minor skin problem, but what it involves is actually the comprehensive state of the body's essence and blood, yin and yang, and the functions of the internal organs. The oiliness of black sesame reminds us: true moisture comes from within. Rather than repeatedly applying various topical products, it is better to look back at one's daily routine, diet, and emotions—those small choices repeated day after day are the fundamental force that determines the body's condition. TCM does not view scaling as an isolated local problem but rather as a barometer of the body's overall state. The next time you see flakes on the back of your head in the mirror, consider: perhaps the body is sending you a gentle reminder—it is time to pause and take better care of yourself.

References:

1. The original text of the Yellow Emperor's Inner Canon · Miraculous Pivot can be consulted in the TCM ancient literature database: https://tcmdata.cintcm.com/

2. WHO strategy document on traditional medicine: https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine

3. Official website of the National Administration of Traditional Chinese Medicine: https://www.satcm.gov.cn/

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